A 32 year old patient complains about heartburn and dull pain in the epigastrium that appear 2-3 hours after meal. Exacerbations happen in spring and in autumn. The patient has food intolerance of eggs and fish. Objectively: stomach palpation reveals painfulness in the gastroduodenal area. Electrophasoduodenoscopy revealed a 5 mm ulcer on the anterior wall of duodenum. Urease test is positive. What is the most probable leading mechanism of disease development?

Correct Answer: A

Rationale: The correct answer is A: Helicobacterial infection. This is the most probable leading mechanism of disease development in this case because the patient's symptoms, such as heartburn, epigastric pain, food intolerance, and presence of a duodenal ulcer with a positive urease test, are classic signs of Helicobacter pylori infection. This bacterium colonizes the stomach lining, leading to inflammation and ulcer formation. The exacerbations in spring and autumn could be due to seasonal variations in immune response. Choice B: Dietary allergy is incorrect because the symptoms and findings in the patient are more indicative of an infectious etiology rather than an allergic reaction to specific foods. Choice C: Autoantibody production is unlikely as there are no indications of an autoimmune process in this case. Choice D: Reduced prostaglandin synthesis is not the leading mechanism as the symptoms and findings are more consistent with an infectious cause rather than a deficiency in prostaglandin synthesis.

Correct Answer: B

Rationale: The correct answer is B: Dysenteric amoeba. 1. Dysenteric amoeba causes amoebiasis, which presents with symptoms like weakness, intestinal pain, and gastrointestinal disorders. 2. The presence of four-nucleus cysts in the feces indicates an infection with Entamoeba histolytica, the causative agent of amoebiasis. 3. Multiple-nucleus cysts are characteristic of Entamoeba histolytica, distinguishing it from other protozoa. 4. Lamblia (choice A), Balantidium (choice C), and Trichomonas (choice D) are not associated with four-nucleus cysts or the mentioned symptoms, making them incorrect choices.

Correct Answer: C

Rationale: The correct answer is C: 8. The embryonic phase in humans lasts until the end of week 8. During this time, the major organs and structures of the body begin to form. After week 8, the developing organism is referred to as a fetus. Choice A (2) is too early for this transition to occur, Choice B (6) is also premature, and Choice D (12) is too late as the embryonic phase ends before week 12. Therefore, the correct answer is C (8) as it accurately reflects the timeline of embryonic development in humans.

Correct Answer: A

Rationale: Rationale for Correct Answer A (Diphtheria): 1. Thin yellow bacilli with dark brown grains on ends suggest Corynebacterium diphtheriae, characteristic of diphtheria. 2. Roman numeral five shape is typical of diphtheria bacilli. 3. Diphtheria causes sore throat and can spread in boarding schools. 4. Neisser staining method is used for diphtheria bacilli. Summary of Incorrect Choices: B: Scarlet fever is caused by Streptococcus pyogenes and presents with rash, not yellow bacilli. C: Listeriosis is caused by Listeria monocytogenes, not consistent with the described findings. D: Tonsillitis can be caused by various bacteria or viruses, but the specific characteristics described do not match.

Correct Answer: A

Rationale: The correct answer is A because adaptive immunity is not mainly observed in the skin and mucous membranes. Adaptive immunity is a systemic response that involves specific immune cells and antibodies targeting specific pathogens. It develops immune memory (B), meaning it can recognize and respond faster upon re-exposure to the same pathogen. Adaptive immunity also has specificity (C), as it can target specific antigens. Lastly, adaptive immunity is not evolutionarily newer in comparison to innate immunity (D), as both systems have co-evolved to provide comprehensive protection against pathogens.

Correct Answer: D

Rationale: The correct answer is D (All of the above) because all three bacteria (Clostridium botulinum, Escherichia coli, Salmonella enterica) are known to cause foodborne infections. Clostridium botulinum can lead to botulism, E. coli can cause various gastrointestinal illnesses, and Salmonella enterica is a common cause of food poisoning. Each bacterium has specific mechanisms that result in foodborne illnesses. Choices A, B, and C are incorrect because each bacterium mentioned is associated with causing foodborne infections, making them collectively the correct answer.

Correct Answer: D

Rationale: The correct answer is D: Kinyoun stain. This stain is the most widely used differential stain in hematology labs because it is specifically designed for acid-fast bacteria like Mycobacterium tuberculosis. It differentiates these bacteria from others based on their cell wall composition. Carbolfuchsin stain (A) is used for acid-fast bacteria in microbiology. Wright's stain (B) is used for blood cell morphology. Ziehl-Neelsen stain (C) is also used for acid-fast bacteria but is less commonly used compared to Kinyoun stain in hematology labs.

Correct Answer: A

Rationale: Ionizing radiation has enough energy to remove tightly bound electrons from atoms, creating charged particles (ions). UV light does not have enough energy to ionize atoms, making choice A the correct answer. Gamma rays, electron beams, and X-rays all have sufficient energy to cause ionization. Gamma rays are very high-energy electromagnetic radiation, electron beams are streams of high-energy electrons, and X-rays are high-energy electromagnetic radiation as well.

Correct Answer: C

Rationale: The correct answer is C: Survival. Bacterial spores are specialized structures that bacteria form to survive harsh conditions such as extreme temperatures or lack of nutrients. Spores are not used for protection against phagocytosis (A) as they are dormant structures and not actively involved in defense mechanisms. They are not for reproduction (B) as spores are a form of bacterial reproduction but not the primary purpose of spore formation. Spores do not serve as nutrient storage (D) as they are mainly used for survival during unfavorable conditions.